Piles are the swollen veins present in the anal region and also in the lower rectum. They may develop internally, that is, inside the rectum, or externally that is, outside the rectum in the anal region and the skin around the anal opening. Piles is also called hemorrhoids, and the problem in veins is similar to that of swollen varicose veins.
How common is piles (hemorrhoids)
It has been estimated that piles occur in people at different times. It has become so common that three out of four adults suffer from piles at a certain point in their life. In various cases, its cause is unknown.
Fortunately, there are various treatments available for all stages of piles (or hemorrhoids). It is advised to focus on adopting lifestyle changes that help prevent the condition. To ensure early treatment, one must know the early signs and symptoms that help them to recognize if they are suffering from the condition.
Piles or hemorrhoids is getting common, and the exact number of patients that suffer from piles or hemorrhoids cannot be accounted for as most of the patients have a tendency to take self-medications and home remedies rather than seeking appropriate medical attention.
Symptoms of Piles
Signs and symptoms of piles depend on the type of piles a person is suffering from that, including:
- 1. Stool with blood
- 2. Painful anal region
- 3. Swelling near the anal opening
- 4. Itching in the rectum or anal region
- 5. Bright red blood dripping in the toilet bowl
- 6. A feeling of the incomplete passage of stool
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Types of Piles (or hemorrhoids)
There are two types of hemorrhoids that differ in the lower region affected, and hence there are slight differences in the symptoms:
Internal hemorrhoids
Internal hemorrhoids are the type of hemorrhoids in which swollen veins occur inside the rectum. There is painless bleeding that can be noticed along with the stool in the toilet or on toilet tissue. Internal hemorrhoids or internal piles are not usually felt easily and do not cause as much discomfort as that external piles or external hemorrhoids.
External hemorrhoids
External hemorrhoids or external piles are the types of hemorrhoids wherein swollen veins occur around the anus. It causes more itching and discomfort in comparison to internal hemorrhoids.
Thrombosed hemorrhoids
The type of piles or hemorrhoids is similar to external hemorrhoids, wherein the pooling of blood occurs externally, which leads to the formation of blood clots, also called thrombus. They cause severe pain, inflammation, and swelling near the anus.
Causes of piles (or hemorrhoids)
The swelling in the anal or rectal veins may occur due to various reasons that lead to the development of hemorrhoids or piles, like:
- 1. Lifting heavier objects regularly
- 2. Suffering from chronic constipation
- 3. Excessive straining while pooping
- 4. Hard stool
- 5. Eating a diet very low in fiber
- 6. Anal intercourse
- 7. Obesity
- 8. Pregnancy
- 9. Low fiber diet
- 10. Spicy food
- 11. Alcohol intake
- 12. The exact cause of piles or hemorrhoid development remains poorly understood and unknown.
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Risk factors
There are various factors that increase the risk of hemorrhoids in an individual. One of the important risk factors is aging. With age, the elasticity and strength of the tissues decline rapidly. In this case, the rectal tissues and anal tissues that support the veins become more stretched and weak. This is the same with pregnant ladies who have to bear the weight of a baby, which puts a lot of pressure on the anal region.
Complications
There are various complications associated with the untreated piles like:
Strangulated hemorrhoids
The complication of hemorrhoids that occurs due to the cessation of blood supply to the internal hemorrhoids is called strangulated hemorrhoids. The condition causes extreme pain and discomfort.
Anemia
Anemia occurs in patients who suffer from piles for a long time and do not pay attention to the chronic blood loss during bowel movement.
Blood clots
Blood clots occasionally occur as a result of the clotting of blood coming from diseased hemorrhoids. The condition is not extremely dangerous but is very painful and sometimes requires drainage.
When to Consult the Doctor
The main symptom that indicates the need to consult a doctor is continuous bleeding with stool. The piles’ symptoms must be taken seriously if it does not go away within a week of appropriate home care.
It is important to talk to the doctor about rectal bleeding as it can indicate other serious health conditions as well. Rectal bleeding also poses the risk of some the cancers like anal cancer or colorectal cancer.
There may be an emergency situation wherein a person may have excessive rectal bleeding, faintness, lightheadedness, and dizziness.
Diagnosis of piles (or hemorrhoids)
The definite diagnosis of piles (or hemorrhoids) is done on the basis of patient history and other clinical examinations.
Assessment with anoscopy and digital examination
Anoscopy is done to detect the size and location of hemorrhoids along with the severity of the condition.
Doctors assess the patient in a squat position to look for prolapse in higher-grade hemorrhoids.
Lifestyle modifications to manage piles (or hemorrhoids)
Lifestyle changes are advised by the doctors to the patients suffering from any degree or grade of piles (or hemorrhoids). Some of the measures to be taken as a treatment or as preventions are:
- 1. Take a diet rich in fiber
- 2. Keep the body and gut hydrated by taking oral fluids
- 3. Reduce intake of fatty foods
- 4. Stick to a regular exercise regime
- 5. Abstain from putting excessive strain in the toilet
- 6. Do not take medications with side effects like diarrhea and constipation
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Medical Treatments for piles (or hemorrhoids):
Oral flavonoids
Oral flavonoids are venotonic drugs that help in treating edema and venous insufficiency. These drugs can enhance vascular tone and decrease capillary permeability. They have an anti-inflammatory effect on veins and facilitate lymphatic drainage. Flavonoids consist of a fraction of hesperidin and diosmin and are one of the most commonly used clinical treatments. The drugs help decrease bleeding and persistent pain, along with a reduction in itching and rectal discomfort.
Calcium dobesilate
The medication is a venotonic drug that has its effect on veins to help alleviate venal problems and treat acute hemorrhoidal symptoms. It has been shown to have an inhibitory effect on platelet aggregation and capillary permeability. It also reduces tissue edema and improves blood viscosity. All of these factors are responsible for significantly improving inflamed hemorrhoids.
Topical Medicines
Topical medications are given in order to control the disease symptoms and therefore require other therapeutic agents along with them to help in curing the disease. Various suppositories and creams are available that can be obtained without a doctor’s prescription. Most the topical medications have anti-inflammatory properties along with ingredients like antibiotics, corticosteroids, and local anesthesia. These medications give the patient temporary relief from the painful passing of stools and bleeding.
Non-surgical treatments for piles (or hemorrhoids):
Ligation with a rubber band
The procedure that uses a rubber band to ligate the hemorrhoidal tissue is the quick and simplest treatment method. It has been observed to be effective in terms of treating the First-degree hemorrhoids or second-degree hemorrhoids and also in some of the patients suffering from third-degree hemorrhoids that are selectively diagnosed by the surgeon and considered appropriate for the procedure.
Sclerotherapy
The treatment option includes injecting chemical agents to fix the mucosa at the base of tissues of prolapsed hemorrhoids. The injecting material contains quinine, hypertonic solution or urea hydrochloride, phenol in oil, and vegetable oil.
Infrared coagulation
The treatment procedure uses infrared radiation that aim at coagulating the tissue, eventually causing the shrinkage of hemorrhoidal tissue. It is not associated with potential complications like the other treatment procedures. Infrared coagulation is a comparatively rapid and safe procedure but is not suitable for large hemorrhoidal tissue.
Cryotherapy
The type of therapy uses a freezing cryoprobe to ablate the rectal or anal hemorrhoids. The treatment causes the destruction of sensory nerves and their ends.
Radiofrequency ablation
It is a newer treatment technique that uses radiofrequency to coagulate the hemorrhoidal tissue and eventually evaporize it. Radiofrequency ablation can be performed as an outpatient procedure. The procedure is considered painless procedure.
Surgical treatments for piles (or hemorrhoids):
Stapled hemorrhoidopexy
The surgical procedure uses a circular stapler-like device to excise or cut out and resuspend the prolapsed hemorrhoids back.
Hemorrhoid Artery ligation
This is a doppler-guided procedure that involves ligating the terminal artery branches of hemorrhoids. This is done to prevent the recurrence and revascularization of hemorrhoids.
Plication
The procedure involves the restoration and anal cushioning to the normal position without making any surgical incisions. It involves tying and oversewing the mass of the hemorrhoid.
Hemorrhoidectomy
This is the most effective surgical treatment that is evident of lowest recurrence in comparison to other procedures. Hemorrhoidectomy is majorly opted for the advanced cases of piles (or hemorrhoids).
Frequently Asked Questions
Q1. What are the major causes of piles (or hemorrhoids)?
Major causes of piles are excessive straining during the passage of stool, chronic constipation, obesity, pregnancy, anal intercourse, and taking a low-fiber diet.
Q2. How to get rid of piles (hemorrhoids) faster?
To get rid of piles faster, take a fiber-rich diet and water frequently, soak in a sitz bath, and use topical creams or medications. If the condition is more complicated, then it requires piles surgery to get treated faster.
Q3. Is piles a serious health condition?
In the beginning, piles are not a serious health condition and can get better if treated early. If the condition is left untreated for a longer time, it may cause life-threatening conditions due to strangulation or cut off of blood supply.
Q4. How to check if I am suffering from piles?
To check for the piles, a person may notice blood after pooping, or there are evident lumps around the anus that cause pain. It is recommended to consult the doctor and get properly diagnosed.
Q5. Do piles last longer?
Uncomplicated piles don’t last for long and can go away with time. But the complicated piles that are painful and cause lots of bleeding after passing stool last if not taken seriously and treated on time.
Q6. What happens if piles are left untreated?
If piles are left untreated, it can cause strangulated hemorrhoids wherein blood supply to internal hemorrhoids gets cut off, or it may become trapped outside the anus. Such a condition cause lot of pain, itching, and discomfort.
Q7. How do piles get worse?
Piles usually get worse when a person tries to put more pressure on the lower rectum while passing stool. Long periods of straining while sitting in the toilet cause worsening piles.
Q8. How to treat piles permanently?
Piles surgery is the permanent treatment for piles. It is crucial to get piles cured before the condition get worse over time. The decision to go for piles surgery must be taken with appropriate doctor consultation and should not be delayed.
Q9. What to avoid in piles?
If a person is suffering from piles, fast foods with high fat and salt content should not be consumed. Processed foods must be eliminated from the diet completely.
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